تأثير مشاوره جنسي گروهي مبتني بر نظريه خودتعيين‌گري بر عملكرد جنسي زنان

Impact of group sexual counseling based on the self-determination theory on women’s sexual function

زﻣﻴﻨﻪ و ﻫﺪف: ﻋﻤﻠﻜﺮد ﺟﻨﺴﻲ ﺑﺨﺶ ﻣﻬﻤﻲ از ﺳﻼﻣﺖ زﻧﺎن اﺳﺖ و از ﻣﺘﻐﻴﺮﻫﺎﻳﻲ ﻛﻪ ﺑـﺎ اﺧـﺘﻼﻻت ﺟﻨﺴـﻲ ﻣﺮﺗﺒﻂ اﺳﺖ، ارﺿﺎي ﻧﻴﺎزﻫﺎي ﺑﻨﻴﺎدﻳﻦ روان ﺷﻨﺎﺧﺘﻲ اﺳﺖ. ﻧﻈﺮﻳﻪ ﺧﻮدﺗﻌﻴﻴﻦ ﮔﺮي از ﻣﻬﻢ ﺗـﺮﻳﻦ ﻧﻈﺮﻳـﻪ ﻫـﺎي اﻧﮕﻴﺰش اﺳﺖ ﻛﻪ ﻋﻠﺖ اﺻﻠﻲ رﻓﺘـﺎر را اﻧﮕﻴـﺰه دروﻧـﻲ ﻓـﺮد ﻣـﻲ داﻧـﺪ و ﻫﻤﭽﻨـﻴﻦ ﺳـﻪ ﻧﻴـﺎز روان ﺷـﻨﺎﺧﺘﻲ ﺧﻮدﻣﺨﺘﺎري، ﺷﺎﻳﺴﺘﮕﻲ و ارﺗﺒﺎط را زﻳﺮﺑﻨﺎي رﻓﺘﺎرﻫﺎي اﻧﺴﺎن ﻣﻲ داﻧﺪ. اﻳﻦ ﻣﻄﺎﻟﻌﻪ ﺑـﺎ ﻫـﺪف ﺗﻌﻴـﻴﻦ ﺗـﺄﺛﻴﺮ ﻣﺸﺎوره ﮔﺮوﻫﻲ ﺟﻨﺴﻲ ﻣﺒﺘﻨﻲ ﺑﺮ ﻧﻈﺮﻳﻪ ﺧﻮدﺗﻌﻴﻴﻦ ﮔﺮي ﺑﺮ ﻋﻤﻠﻜﺮد ﺟﻨﺴﻲ زﻧﺎن اﻧﺠﺎم ﮔﺮﻓﺘﻪ اﺳﺖ. روش ﺑﺮرﺳﻲ: اﻳﻦ ﻛﺎرآزﻣﺎﻳﻲ ﺑﺎﻟﻴﻨﻲ در ﻣﻮرد 104 زن ﻣﺘﺄﻫﻞ 18ﺗﺎ49 ﺳﺎﻟﻪ ﻣﺮاﺟﻌﻪ ﻛﻨﻨﺪه ﺑـﻪ ﻣﺮاﻛـﺰ ﺑﻬﺪاﺷـﺘﻲ درﻣﺎﻧﻲ ﻣﺸﻬﺪ در دو ﮔﺮوه ﻣﺪاﺧﻠﻪ و ﻛﻨﺘﺮل در ﺳﺎل 1398 اﻧﺠﺎم ﮔﺮﻓﺘﻪ اﺳﺖ. ﮔﺮوه ﻣﺪاﺧﻠـﻪ5 ﺟﻠﺴـﻪ ﻣﺸـﺎوره ﺟﻨﺴﻲ ﮔﺮوﻫﻲ 2 ﺳﺎﻋﺘﻪ ﻣﺒﺘﻨﻲ ﺑﺮ ﺳﺎزه ﻫﺎي ﻧﻈﺮﻳﻪ ﺧﻮدﺗﻌﻴﻴﻦ ﮔﺮي ﺑﺎ ﻓﻮاﺻﻞ ﻳﻚ ﻫﻔﺘﻪ درﻳﺎﻓﺖ ﻧﻤﻮدﻧﺪ. داده ﻫﺎ ﺑﺎ اﺳـﺘﻔﺎده از ﭘﺮﺳﺸــﻨﺎﻣﻪ ﻫــﺎي ﻋﻤﻠﻜــﺮد ﺟﻨﺴـﻲ زﻧــﺎن و ﺳــﺎزه ﻫــﺎي ﻧﻈﺮﻳـﻪ ﺧــﻮدﺗﻌﻴﻴﻦ ﮔــﺮي )ﻧﻴﺎزﻫــﺎي ﺑﻨﻴــﺎدﻳﻦ روان ﺷﻨﺎﺧﺘﻲ در ﻓﻌﺎﻟﻴﺖ ﺟﻨﺴﻲ( ﻗﺒﻞ و ﺑﻌﺪ از ﻣﺪاﺧﻠﻪ ﺟﻤﻊ آوري و در ﻧﺮم اﻓﺰار SPSS ﻧﺴﺨﻪ 16 و ﺑﺎ اﺳﺘﻔﺎده از آزﻣﻮن ﻫﺎي ﺗﻲ ﻣﺴﺘﻘﻞ، ﺗﻲ زوﺟﻲ، ﻣﻦ وﻳﺘﻨﻲ و وﻳﻠﻜﺎﻛﺴﻮن ﻣﻮرد ﺗﺠﺰﻳﻪ و ﺗﺤﻠﻴﻞ ﻗﺮار ﮔﺮﻓﺖ. ﻳﺎﻓﺘﻪ ﻫﺎ: ﻣﻴﺎﻧﮕﻴﻦ ﻧﻤﺮه ﻋﻤﻠﻜﺮد ﺟﻨﺴﻲ ﻗﺒﻞ از ﻣﺪاﺧﻠﻪ ﺑﻴﻦ دو ﮔﺮوه، اﺧﺘﻼف آﻣﺎري ﻣﻌﻨـﺎداري ﻧﺪاﺷـﺖ، اﻣـﺎ ﺑﻌﺪ از ﻣﺪاﺧﻠﻪ، اﺧﺘﻼف ﻣﻴﺎﻧﮕﻴﻦ ﻧﻤﺮات ﻋﻤﻠﻜﺮد ﺟﻨﺴﻲ ﻗﺒﻞ و ﺑﻌﺪ از ﻣﺪاﺧﻠﻪ، در ﮔﺮوه ﻣﺪاﺧﻠﻪ 2/76 ±3/02 و در ﮔﺮوه ﻛﻨﺘﺮل 0/25 ±0/73- ﺑﻮد ﻛﻪ اﻓﺰاﻳﺶ ﻣﻌﻨﺎداري در ﻧﻤﺮه ﻋﻤﻠﻜﺮد ﺟﻨﺴﻲ ﮔـﺮوه ﻣﺪاﺧﻠـﻪ ﻧﺴـﺒﺖ ﺑـﻪ ﻛﻨﺘﺮل ﻣﺸﺎﻫﺪه ﺷﺪ )0/001

Background & Aim: Sexual function is an important part of the health of women, and the satisfaction of basic psychological needs is among the variables related to sexual dysfunction. The self-determination theory is one of the most important motivational theories, which considers one’s internal motive the main cause of behavior, and also views three psychological needs (autonomy, relatedness, and competence) as the basis of human behavior. This study was to determine the effect of sexual consulting based on the self-determination theory on women’s sexual function. Methods & Materials: This clinical trial was conducted on 104 married women aged 18 to 49 years referred to Mashhad health centers in two groups of intervention and control in 2019. The intervention group received five sessions of two-hour group counseling based on the constructs of self-determination theory, with intervals of one week. The data was collected using the sexual performance questionnaire and the constructs of self-determination theory (basic psychological needs) before and after the intervention. Data was analyzed using the SPSS software version 16 through independent t-test, paired t-test, Mann-Whitney and Wilcoxon tests. Results: There was no statistically significant difference between the two groups in the average score of sexual function before the intervention. However, after the intervention, the difference in the average score of sexual function between before and after the intervention was 2.76±3.02 for the intervention group and -0.25±0.73 for the control group, which showed a significant increase in the sexual function score of the intervention group compared to the control (P<0.001). Moreover, after the intervention between the intervention and control groups, a statistically significant difference was observed in the average scores of autonomy, competence and relatedness (P<0.001). Conclusion: Providing group sexual counseling based on the self-determination theory can satisfy the basic needs relating to sexuality and improve women's sexual performance.